The GLP-1 Economy: Who Wins and Loses

The American consumer economy was built on a simple assumption: that people want more. More volume, more snacks, more calories, one more drink.

A class of prescription drugs has started to undo that assumption for a growing slice of the country. PwC titled its 2026 research on the subject “The end of more” [1]. That is a marketing phrase, but the spending data behind it is real.

Here is what the evidence shows about who gains and who loses - and where the hype runs ahead of the numbers.

How much does GLP-1 use actually change household spending?

This is the foundation for everything else, and there is now solid evidence rather than guesswork.

Researchers at Cornell’s Dyson School of Applied Economics and Management, working with the market research firm Numerator, matched survey answers about GLP-1 use to transaction records for about 150,000 US households. The study was published in the Journal of Marketing Research on December 18, 2025 [2]. Rather than asking people what they ate, it counted what they bought.

The headline findings [2]:

• Grocery spending falls an average of 5.3% within six months of starting a GLP-1
• Higher-income households cut more than 8%
• Spending at fast-food restaurants, coffee shops and other limited-service eateries falls about 8%
• Ultra-processed categories fell hardest: savory snacks dropped about 10%, with comparable declines in sweets, baked goods, cookies, bread, meat and eggs
• Yogurt showed the largest gain, followed by fresh fruit, nutrition bars and meat snacks - though the increases were modest against the overall decline

Earlier working-paper figures put the grocery decline closer to 6%, or about $416 per household per year, rising to about $690 for households earning over $125,000 [3].

PwC’s 2026 analysis, also using Numerator data (a May 2026 transaction-panel refresh of roughly 110,000 households at six to eight months post-start) plus a survey of 3,089 consumers fielded May 4 to 9, 2026, found a consistent picture: grocery spending down 5.5%, with 61% of current users buying fewer sweet treats and 56% buying fewer salty snacks, while 44% bought more fresh produce [1]. Quick-service restaurant spending per GLP-1 household was down 8.7%, with pizza down 22.2%, chicken 11.6%, coffee and bakery 8.0%, burgers 6.4% and sandwiches and delis 4.5% [1].

One number reframes all of this. PwC found that about 21% of US households included a current GLP-1 user as of May 2026, up from 9% in January 2025 [1]. Circana has projected that GLP-1 households will account for more than a third of US food and beverage sales by 2030 [4].

Who is losing in food and beverage?

Packaged snacks and indulgence categories. J.P. Morgan Research estimates GLP-1 treatments will cut $30 billion to $55 billion in annual food and beverage revenue by 2030-2034, assuming users take in 21% fewer calories and spend 31% less on groceries [5]. Morgan Stanley has estimated that consumption of carbonated soft drinks, baked goods and salty snacks could decline 3% by 2035 [6].

FTI Consulting’s 2026 category analysis put frozen foods, ice cream, soft drinks, juices, salty snacks, cookies and alcohol firmly in the “likelihood to decrease” column.

Beverages. Cornell/Numerator six-month data show soft drinks down about 7.0% annualized, coffee and energy drinks down 4.0%, juices down 4.0% and alcohol down 1.4% for GLP-1 households [7].

Alcohol specifically has become a structural worry rather than a cyclical one. A study of more than 14,000 WeightWatchers members found 45.3% of GLP-1 patients who previously drank at least weekly reported drinking less after starting [7]. EY found that among drinkers who cut back, wine fell most at 52%, followed by beer at 43% and spirits at 40% [8]. UK fund manager Terry Smith cited weight-loss drugs when explaining his exit from Diageo, writing that the entire drinks sector may be in the early stages of a negative impact [7].

There is also clinical evidence pointing the same direction: randomized trial work has shown semaglutide reduced heavy drinking days and cravings in people with alcohol use disorder.

But the losses are not universal, and it is worth saying so. FoodNavigator-USA reported in March 2026 that aggregate snack sales had held steady, with major manufacturers and grocers attributing only minimal impact on grocery sales so far. Mondelez CEO Dirk Van de Put told analysts GLP-1s would have a “minimal” effect on his company’s volumes, arguing that any shift toward protein “is not because of GLP-1” [9].

Who is winning in food?

Protein and fiber, in almost any format. PwC found GLP-1 households buying more Greek yogurt (up 6.8%), jerky (up 7.9%), energy drinks (up 7.0%) and nutrition bars (up 3.4%) [1]. The logic is simple: if you can only eat a little, every bite has to work harder. Clinicians advising GLP-1 users emphasize protein for muscle retention and fiber for the constipation the drugs can cause.

Companies that moved early. Nestlé launched Vital Pursuit in 2024 - its first major new US brand in nearly three decades - as portion-controlled, protein- and fiber-rich frozen meals for GLP-1 users [9]. Conagra added a “GLP-1 friendly” label to about two dozen Healthy Choice frozen meals, the first mainstream on-pack call-out in a US grocery aisle to name a drug class [9]. Danone rolled out an Oikos yogurt drink aimed at GLP-1 users.

Conagra’s reasoning is worth quoting, because it is the whole strategy in one sentence. Bob Nolan, the company’s senior vice president of demand science, framed it as acquiring customers while they are on the drug and keeping them afterward: “We want to have products that are there for them when they’re getting on to GLP-1s. And then… once you’ve achieved your target weight, what’s your new goal? Your new goal is to maintain” [9].

General Mills CEO Jeff Harmening gave the clearest CEO-level acknowledgment at the Consumer Analyst Group of New York conference in February 2026: “Anti-obesity drugs will have a lasting influence on the food market” [9]. The company responded with smaller pack sizes, Honey Nut Cheerios Protein, Ghost nutrition bars and new granola lines.

Retailers who sell the drugs themselves. Walmart was the first to publicly confirm that GLP-1 shoppers buy less food, but its CFO also noted those customers “tend to spend more with us overall” because of the prescriptions [10]. Costco, Sam’s Club, Walmart, CVS and Amazon have all built discounted self-pay GLP-1 offers. CNBC reported in August 2026 that retailers increasingly value the ecosystem around the medication more than the thin margin on the drug itself.

What is happening to restaurants?

Less damage than the headlines suggested, and a clear split by daypart.

CNBC reported in March 2026 that dinner traffic among consistent GLP-1 users was down about 6%, which translates to roughly a 0.4% decline in overall restaurant dinner sales [11]. Breakfast has taken a hit among higher-income users - fewer sugary coffee drinks and pastries. Lunch has been largely unaffected.

A 2026 analysis reported by Restaurant Business concluded that even a doubling of GLP-1 usage over five years would affect industry sales growth by less than 1% and traffic by about 5% [12].

And one finding cuts directly against the doom framing: a National Restaurant Association survey of 1,400 US adults - 509 of them current GLP-1 users - fielded March 6 to 11, 2026 and published that May found GLP-1 users bought a restaurant meal, snack or beverage an average of 7.6 times in the prior week, versus 5.1 times for non-users [13][27]. Nearly half of those users also said they use restaurants less than before starting the medication; both things are true at once. People on these drugs eat out more often than the average American. They just order differently.

Chains noticed. Smoothie King launched GLP-1 menu items in late 2024, and Chipotle and Shake Shack followed in December 2025 [13]. Smoothie King’s GLP-1 smoothies carry 19 to 45 grams of protein, zero added sugar and 190 to 450 calories. Chipotle’s high-protein menu includes a high protein-high fiber bowl and a high protein-low calorie salad. Shake Shack’s “good fit” menu includes bunless burgers. Burger King has said it plans to test protein-forward bowls and Whopper bites partly because of GLP-1 growth.

What GLP-1 users say they want is straightforward and mostly unmet. PwC found 35% asking for smaller portions at proportionally lower prices and 32% wanting half-portions or split plates without an upcharge [1]. Half of current and lapsed users said restaurants have not caught up.

What is happening to clothing?

This is the most genuinely disrupted retail category, and it cuts both ways.

The win: PwC found apparel spending up 9.9% among GLP-1 households after six to eight months, with 73% reporting a meaningful change in clothing size and 26% spending more on clothes overall [1]. Within that, women’s jeans were up 66.1%, jewelry 36.4%, swimwear 31.1% and dresses 22.1%. Bernstein has estimated GLP-1-driven wardrobe replacement could add up to $13 billion in annual US apparel spending [14].

The loss: plus-size specialists. Destination XL reported fourth-quarter fiscal 2025 sales down 6% year over year to $112.1 million, with comparable sales off 7.3% and a net loss of $29.6 million against $1.3 million a year earlier; full-year sales fell 6.9% to $435 million [15][31]. Its CEO told analysts that GLP-1 use, estimated among about 25% of its customers, was moving people between sizes and creating “volatility” [15]. In December 2025 the company agreed to an all-stock merger of equals with FullBeauty Brands, a plus-size women’s direct-to-consumer retailer, to form a roughly $1.2 billion inclusive-apparel business - a consolidation play by two companies on the same side of this shift [31].

The operational headache: nobody knows what size anyone will be next season. Retail Dive quoted Circana apparel adviser Kristen Classi-Zummo: “With GLP-1 adoption accelerating, size is changing, but so is identity… This isn’t a trend - it’s a structural” shift [15]. PwC noted that users drop sizes faster than they commit to new wardrobes because they do not know where they will land in three months [1].

The response has been uneven. The Guardian reported in August 2026 that some brands are pruning larger garments and switching from numeric to alpha sizing - medium instead of size 14 - because alpha sizes absorb body fluctuation better [16]. NewsNation reported concern that extended sizes are moving from store shelves to online only. Meanwhile CNBC reported that in March 2026, purchase volume for large, extra-large and plus-size apparel combined still grew 6% year over year while small and medium fell 6% [17] - a reminder that the plus-size customer has not gone anywhere.

What about airlines, gyms and the other second-order effects?

Airlines. A January 2026 Jefferies analysis estimated that lighter passengers could save American, Delta, Southwest and United as much as $580 million in jet fuel in a year, against a combined expected fuel spend of $38.6 billion [18]. The model assumes a 10% societal slim-down producing a 2% drop in total passenger weight, 1.5% fuel savings and a 4% boost to earnings per share. The worked example: a Boeing 737 MAX 8 carrying 178 passengers at an average 180 pounds has a takeoff weight of 181,200 pounds; if average passenger weight drops to 162 pounds, that falls to 177,996 pounds [18]. United has separately estimated a 10-pound average drop would save it about $80 million a year.

Take it as a model, not a measurement. Economist Matthew Kahn has argued that airlines optimize routes and seating continuously, so some of the savings will be captured by flying faster or adding seats rather than showing up as reduced fuel burn.

Gyms. The industry expected to lose and has repositioned to win. Equinox launched a training program for people losing weight on GLP-1s. Gold’s Gym in the Washington, D.C. area partnered with a wellness firm to offer members discounts on the drugs themselves. Planet Fitness said about half of GLP-1 users consider a gym membership and that it was in conversations with GLP-1 providers [19]. In its 2026 Worldwide Fitness Trends survey the American College of Sports Medicine ranked exercise for weight management its No. 3 trend, up from No. 4 in 2024 and 2025 and No. 8 in 2023 - its highest placement to date - explicitly tying the move to rising use of obesity medications including GLP-1 receptor agonists.

The opening is specific: PwC found 41% of current GLP-1 users have never done strength training [1]. Cardio is where they are active - 36% increased walking, running, cycling or swimming - while group fitness is under mild pressure.

Medical devices and surgery. An analysis released February 18, 2026 by Cedar Gate Technologies, an IQVIA business, found bariatric surgery volume down 13% over a year while members taking GLP-1s rose 67% over two years [20][32]. Independent work points the same way: a University of California San Diego analysis of records for nearly 20 million patients with severe obesity, presented at the American Society for Metabolic and Bariatric Surgery meeting in May 2026, found bariatric procedures in that population falling from 42,615 in 2023 to 33,429 in 2025 while GLP-1 prescriptions rose from 457,399 to more than 1.4 million [33]. Average bariatric surgery cost $24,215 in 2024 against roughly $5,200 a year per patient for GLP-1 prescriptions.

Sleep-apnea device maker ResMed became the test case for device-sector fear. Its stock sold off in 2023 on the theory that weight loss would shrink the CPAP market. ResMed responded with claims data across about 1.95 million patients showing that patients prescribed both a GLP-1 and CPAP were 10% to 11% more likely to start therapy, with more than 6% higher resupply rates after three years. CEO Mick Farrell said “the thesis that this could be a headwind is completely gone.” Morgan Stanley downgraded the stock anyway in June 2026, citing GLP-1 and competitive pressure. Both sides are still arguing.

WeightWatchers. The cleanest casualty. The company that defined commercial dieting for sixty years lost Oprah Winfrey from its board in February 2024 after she disclosed GLP-1 use. Parent WW International filed a prepackaged Chapter 11 in Delaware on May 6, 2025, emerged as a private company on June 24, 2025 having shed about $1.15 billion of roughly $1.6 billion in debt, and pivoted to clinical weight management. By July 2026 a WeightWatchers-linked benefit was being bundled as a Sam’s Club membership perk.

Who is winning at the top of the chain?

Eli Lilly became the first drugmaker valued at $1 trillion on November 21, 2025, driven by tirzepatide. Over the first nine months of 2025 Zepbound and Mounjaro together sold nearly $19 billion, making tirzepatide the world’s best-selling drug ahead of Merck’s Keytruda. Full-year 2025 revenue came in at $65.2 billion, up about 45% from 2024 [21][28].

Novo Nordisk’s story went the other way. The company’s market capitalization once exceeded Denmark’s annual GDP. Then on September 10, 2025 it announced it would cut about 9,000 jobs, roughly 11% of its 78,400-person workforce, including about 5,000 in Denmark - reported as the largest single layoff in Danish history - to save 8 billion Danish kroner (about $1.25 billion) a year by the end of 2026, as US growth slowed and Lilly gained share [22]. It was the first major move by Mike Doustdar, who became chief executive in August 2025.

Wall Street’s own forecasts have been marked down repeatedly. Goldman Sachs cut its 2030 global obesity-drug estimate from $130 billion to $95 billion in May 2025 [23], and Reuters reported it at roughly $105 billion by early 2026, with the industry’s $150 billion target shifting from 2030 to 2035 [24]. Morgan Stanley projects about $190 billion by 2035 [6].

The reason is price, not volume. As list prices fall and self-pay channels expand, the market gets larger in patients and smaller in dollars per patient.

Who is the loser nobody planned for?

Employer coverage of GLP-1s for weight loss expanded sharply and then began contracting.

KFF’s 2025 Employer Health Benefits Survey found 19% of firms with 200 or more workers covered GLP-1s primarily for weight loss - 16% at 200 to 999 workers, 30% at 1,000 to 4,999, and 43% at 5,000 or more, up from 28% the prior year [25]. Thirty-four percent of covering firms required enrollees to see a dietitian, case manager or therapist, or join a lifestyle program.

Then the bills arrived. Forty-four percent of firms with 1,000 to 4,999 workers and 59% of those with 5,000 or more said use was higher than expected, and 64% of large firms said GLP-1 coverage moderately or significantly affected prescription drug spending [25]. One benefits director told KFF researchers: “I’ll just say our GLP-1 agonist spending year over year was increasing 50% for weight loss.”

Business Group on Health’s 2027 Employer Healthcare Strategy Survey, released August 25, 2026, found the share of large employers covering GLP-1s for weight management falling to 60% in 2026 from 72% in 2025, with 14% saying they have already eliminated weight-loss coverage or plan to in 2027 [26][29]. An earlier Business Group on Health survey of 105 employer members, fielded in February and March 2026, found 67% still covering GLP-1s for weight management but only 72% of that group likely to continue into 2027, and nearly eight in 10 reporting that GLP-1s were pushing up overall health care costs [30]. Mercer separately reported that 44% of employers with more than 500 workers cover the drugs for obesity and 5% are actively planning to drop that coverage [30].

What is still unknown?

Three honest gaps:

1. How long people stay on. Northwestern Medicine clinicians estimate that 50% to 75% of people who start these drugs stop within a year - an estimate widely repeated in clinical and trade reporting, not a single trial result [34]. Cornell found about a third of users in its sample quit, with spending drifting back toward pre-adoption levels [2]. Every long-run forecast is sensitive to this number, and nobody has it nailed down.
2. Whether this is a trend or a plateau. Morningstar’s Erin Lash noted that food companies still ask privately whether GLP-1s will fade like Atkins or South Beach, while adding that it is prudent to plan for permanence [9].
3. Productivity and workplace effects. Employer cost data is solid. Evidence on absenteeism, productivity or long-run health spending offsets is thin. Anyone citing a hard number there is extrapolating.

What is the short version?

Gaining: protein and fiber brands, fresh produce, yogurt and meat snacks, apparel (in aggregate), gyms selling strength training, retailers and telehealth platforms selling the drugs, and Eli Lilly.

Losing: salty snacks, cookies, sweet bakery, soft drinks, juices, alcohol, plus-size specialty apparel, bariatric surgery volume, commercial dieting programs, and employer benefits budgets.

Still contested: restaurants overall, sleep-apnea devices, and the total size of the drug market itself.

Nothing in this article is investment advice or medical advice. It is a map of where the money is moving, built from company disclosures, purchase-panel data and published research - and like any map of a fast-moving landscape, parts of it will be out of date before long.

Sources

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2. Cornell Chronicle, “Ozempic is changing the foods Americans buy” (December 19, 2025) — https://news.cornell.edu/stories/2025/12/ozempic-changing-foods-americans-buy
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33. American Society for Metabolic and Bariatric Surgery, “As GLP-1 Use Skyrockets and Bariatric Surgery Slows, Most Obesity Goes Untreated” (May 5, 2026) — https://asmbs.org/news_releases/as-glp-1-use-skyrockets-and-bariatric-surgery-slows-most-obesity-goes-untreated
34. Northwestern Now, “Why do 50-75% of people stop taking GLP-1 drugs within a year?” (November 8, 2024) — https://news.northwestern.edu/stories/2024/11/why-do-50-75-of-people-stop-taking-glp-1-drugs-within-a-year